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Mobility related physical and functional losses due to aging and disease - a motivation for lower limb exoskeletons

Grimmer, Martin ; Riener, Robert ; Walsh, Conor James ; Seyfarth, André (2022)
Mobility related physical and functional losses due to aging and disease - a motivation for lower limb exoskeletons.
In: Journal of NeuroEngineering and Rehabilitation, 2019, 16
doi: 10.26083/tuprints-00013136
Article, Secondary publication, Publisher's Version

Copyright Information: CC BY 4.0 International - Creative Commons, Attribution.

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Item Type: Article
Type of entry: Secondary publication
Title: Mobility related physical and functional losses due to aging and disease - a motivation for lower limb exoskeletons
Language: English
Date: 2022
Place of Publication: Darmstadt
Year of primary publication: 2019
Publisher: Springer
Journal or Publication Title: Journal of NeuroEngineering and Rehabilitation
Volume of the journal: 16
Collation: 21 Seiten
DOI: 10.26083/tuprints-00013136
Corresponding Links:
Origin: Secondary publication

Background: Physical and functional losses due to aging and diseases decrease human mobility, independence, and quality of life. This study is aimed at summarizing and quantifying these losses in order to motivate solutions to overcome them with a special focus on the possibilities by using lower limb exoskeletons.

Methods: A narrative literature review was performed to determine a broad range of mobility-related physical and functional measures that are affected by aging and selected cardiovascular, respiratory, musculoskeletal, and neurological diseases.

Results: The study identified that decreases in limb maximum muscle force and power (33% and 49%, respectively, 25–75 yrs) and in maximum oxygen consumption (40%, 20–80 yrs) occur for older adults compared to young adults. Reaction times more than double (18–90 yrs) and losses in the visual, vestibular, and somatosensory systems were reported. Additionally, we found decreases in steps per day (75%, 60–85 yrs), maximum walking speed (24% 25–75 yrs), and maximum six-minute and self-selected walking speed (38% and 21%, respectively, 20–85 yrs), while we found increases in the number of falls relative to the number of steps per day (800%), injuries due to falls (472%, 30–90 yrs) and deaths caused by fall (4000%, 65–90 yrs). Measures were identified to be worse for individuals with impaired mobility. Additional detrimental effects identified for them were the loss of upright standing and locomotion, freezing in movement, joint stress, pain, and changes in gait patterns.

Discussion: This review shows that aging and chronic conditions result in wide-ranging losses in physical and sensory capabilities. While the impact of these losses are relatively modest for level walking, they become limiting during more demanding tasks such as walking on inclined ground, climbing stairs, or walking over longer periods, and especially when coupled with a debilitating disease. As the physical and functional parameters are closely related, we believe that lost functional capabilities can be indirectly improved by training of the physical capabilities. However, assistive devices can supplement the lost functional capabilities directly by compensating for losses with propulsion, weight support, and balance support.

Conclusions: Exoskeletons are a new generation of assistive devices that have the potential to provide both, training capabilities and functional compensation, to enhance human mobility.

Status: Publisher's Version
URN: urn:nbn:de:tuda-tuprints-131368
Additional Information:

Keywords: Exoskeleton, Assistance, Aging, Walking, Mobility, Impaired, Motivation

Correction: urn:nbn:de:tuda-tuprints-202900

Classification DDC: 600 Technology, medicine, applied sciences > 620 Engineering and machine engineering
700 Arts and recreation > 796 Sports
Divisions: 03 Department of Human Sciences > Institut für Sportwissenschaft
03 Department of Human Sciences > Institut für Sportwissenschaft > Sportbiomechanik
Date Deposited: 28 Mar 2022 12:11
Last Modified: 28 Feb 2023 12:41
URI: https://tuprints.ulb.tu-darmstadt.de/id/eprint/13136
PPN: 505350548
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